Yoon Tae-Mi, Lim Sang-Chul, Jung Shin
Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Research Institute of Medical Sciences, Chonnam National University Hwasun Hospital and Medical School, Hwasun, South Korea.
Acta Otolaryngol. 2008 Jul;128(7):785-9. doi: 10.1080/00016480701730752.
Use of a sphenoid mucosal flap in transsphenoidal surgery decreased the incidence of postoperative cerebrospinal fluid (CSF) leaks and promoted wound healing of the sphenoid sinus.
To evaluate the effectiveness of sphenoid mucosal flaps for the reconstruction of the sellar floor after transsphenoidal surgery.
Patients who underwent transnasal transsphenoidal surgery were reviewed. Data on materials used for the sellar reconstruction, presence of postoperative CSF leaks, duration of lumbar drainage and local wound complications of the sphenoid sinus were collected.
Sphenoid mucosal flaps were used in 46 cases but not in 22 cases. An intersinus septal mucosal flap was most commonly used. Total mucosal covering was possible in 43 cases, partial covering in 3 cases and no covering in 22 cases. Postoperative CSF leaks occurred exclusively in six patients with partial or no mucosal covering. The duration of lumbar drainage was shorter in patients with a total mucosal covering than in those with a partial or no mucosal covering (average 4.3 days vs 11.7 days, p=0.003). Local wound complications of the sphenoid sinus occurred more frequently in patients with no mucosal covering than in patients with a mucosal covering (5/22, 22.7% vs 1/46, 2.1%, respectively, p=0.012).
在经蝶窦手术中使用蝶窦黏膜瓣可降低术后脑脊液漏的发生率，并促进蝶窦伤口愈合。
评估蝶窦黏膜瓣在经蝶窦手术后重建鞍底的有效性。
对接受经鼻经蝶窦手术的患者进行回顾性研究。收集有关鞍底重建所用材料、术后脑脊液漏的发生情况、腰大池引流时间以及蝶窦局部伤口并发症的数据。
46例患者使用了蝶窦黏膜瓣，22例未使用。最常用的是蝶窦间隔黏膜瓣。43例实现了完全黏膜覆盖，3例为部分覆盖，22例未覆盖。术后脑脊液漏仅发生在6例部分或未行黏膜覆盖的患者中。完全黏膜覆盖患者的腰大池引流时间短于部分或未覆盖患者（平均4.3天对11.7天，p = 0.003）。蝶窦局部伤口并发症在未行黏膜覆盖患者中的发生率高于行黏膜覆盖患者（分别为5/22，22.7%对1/46，2.1%，p = 0.012）。
